Former legislator John Burris and the Health Task Force consulting contract kerfuffle

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Inside baseball side note to the drama we reported on this morning (the Health Reform Legislative Task Force voted 9-7 to award a consulting contract to the Stephen Group; the task force leadership didn't like the choice and is now seeking to nix the contract that the majority voted for):

John Burris, the former Republican state legislator who was a key architect of the private option and is now a lobbyist "consultant" working with Bill Vickery's Capitol Advisors Group, has a stake in this fight. Public Consulting Group (PCG) is a client of Burris and the Capitol Advisors Group. Vickery, Burris, and co. can't legally communicate with lawmakers during a the "blackout" period while the procurement process is active (and no lawmaker has told me they were directly lobbied during this process), but everyone knows what side Burris is on, and, well, let's just say that Burris still has strong friends and enemies in the legislature.

Centene is also a client of Burris and the Capitol Advisors Group. Centene (which offers insurance in Arkansas, including via the private option, under the name Ambetter) has worked with PCG in the past. Centene has also been a player in other states in Medicaid managed care, and was recently in the news after a court found it in breach of contract for backing out as a Medicaid managed care organization (MCO) in Kentucky, walking away from 100,000 Medicaid patients before its contract was up. (In Medicaid managed care arrangements, MCOs contract with state agencies to set reimbursement payments for providers and deliver services to beneficiaries.)

Some Democrats opposed to Medicaid managed care stated that they are skittish about PCG because they were worried it might be more friendly to the idea of bringing Medicaid managed care to Arkansas. Meanwhile, Democrats and lobbyists opposed to Medicaid managed care have floated rumors that Centene is advocating for it behind the scenes, so PCG's past associations with Centene (and the fact that both are clients of Burris), may have contributed to this skittishness.

In practice, there is no concrete evidence that PCG is any more or less open to concept of Medicaid managed care than the Stephen Group, and nothing in the two groups' proposals suggests a major difference on this issue.

To repeat, no legislators have said that they were directly lobbied on this contract by Burris or anyone else from Capitol Advisors Group (in addition to the procurement blackout period, Burris is legally disallowed from lobbying at all because he is still in the "cooling off" period after being a legislator — though of course most believe those rules have a whole lot of wink-wink wiggle room). That said, Burris is clearly carving out influence in the health care space and because of his legislative past — both his major role in passing the private option and his history of aggressive scuffling with Democrats — he is inevitably going to be a lightning rod in these debates. His name, as you'd expect, is coming up when legislators complain about this week's power move by Rep. Charlie Collins (a Burris pal) and Sen. Jim Hendren to block the consulting contract the task force voted to recommend for the Stephen Group.

Vickery, of Capitol Advisors Group, sent the following statement about this kerfuffle:

For people to vote against PCG because we also represent another client who may want to see managed care implemented is beyond stupid. We also represent Entergy so are they going off the electrical grid too? The task force is charged with a huge responsibility and most members take it seriously and work in the best interest of the state—not some weird connect-the-dots conspiracy theory.